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Device helps patients with abnormal heartbeat without touching the heart

Our Lady of Lourdes Medical Center has become one of only a few hospitals in the South Jersey region to implant subcutaneous implantable defibrillators (S-ICD). The cardiac device is the first and only one of its kind that provides defibrillator therapy without touching the heart.

The small, battery-powered device works by constantly monitoring a person’s heart rhythm. It can deliver a therapeutic dose of electricity to restore the rhythm when it senses the heart is beating dangerously fast (tachycardia) or chaotically (sudden cardiac arrest).

“The S-ICD system provides an exciting alternative for patients with life-threatening heart arrhythmias who are not good candidates for a standard defibrillator,” said Devender N. Akula, MD, FACC, cardiologist with Lourdes Cardiology Services. “The device offers less risk in selected patients since a wire (lead) is not required to be placed in the heart.”

The S-ICD is implanted under the skin, on the side of the chest below the arm pit. A defibrillator (or pulse generator) sits under the arm pit. An electrode from the device pocket is positioned along the side of rib margin and the breastbone.

Ideal candidates for this new device include younger patients, patients with certain genetic disorders and those with special vascular conditions, such as hemodialysis patients, said Dr. Akula.

“The advantage of the S-ICD device is its durability – the wire can potentially last longer because it doesn’t get exposed to the same stress as a standard implantable defibrillator wire does – a constant stress of the beating heart and friction from bone and subcutaneous tissues,” said Dr. Akula. “This potentially makes the system more durable. This is enticing for younger cardiac patients in whom, with current standard defibrillators, are eventually exposed to wire failures and its associated complications.”

Dr. Akula says the S-ICD system also benefits hemodialysis patients whose blood vessels may be damaged or collapsed from dialysis.

Sudden cardiac death (SCD) accounts for about 300,000 deaths annually in the US, of which 75 percent to 80 percent are due to ventricular fibrillation, according to the National Institutes of Health.

The S-ICD has been used in Europe and New Zealand since 2009 and was approved by the U.S. Food and Drug Administration in 2012.

Added Dr. Akula, “The S-ICD won’t replace standard implantable defibrillators because many patients who need an implantable defibrillator also need a pacemaker to keep the heart beating regularly. This new device does not pace the heart. It will, however, be a valuable alternative for patients who don’t need pacemaker function.”